Newbie at the bottom of learning curve

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KarenAmelia

Member Since 2012
Just introducing myself. My 15 year old cat was just diagnosed with diabetes last week, and I'm learning about BG curves and am on about day 3 of insulin shots. I'm grateful for such a wealth of internet resources on cat diabetes! Am hoping it's not too late for my cat to regain good health. The vet put her on 1.5 units/ twice daily of Lantus, and while yesterday she seemed closer to her old self (and BG had dropped from 383 to 210 at 9hours post injection) today she is worse again with a BG of 340 at 3hours post injection. I'm worried. Is this kind of fluctuation normal?

I see that there is a lot of contradictory advice about diet- type and schedule. I've been feeding IAMS dry food for years and am now suspecting that the high carbs in this food, combined with feeding on demand, may have contributed to the onset of diabetes in my cat. I want to switch to a high protein diet, but am confused: what if she has suffered kidney damage and thus should have a low protein diet? This is one question for my vet, who told me to save up questions until our next meeting (but I thought I'd ask here.) And I don't know if I should change the feeding schedule, cold turkey, from on demand to once or twice daily , and should that be at injection time or at the nadir of the BG curve? Since the cat has lost a lot of muscle , it seems maybe safer to let her eat often. I'm sure the folks on this forum also have a wide range of opinions about what is best , but for what it's worth I'm putting these questions out for anyone who cares to respond.

Thanks. Karen
 
You're not at the bottom of the learning curve at all. You have lots of good ideas already. Many of us like to feed several small meals during the day and night. We feel it helps the pancreas to heal. Some of us freeze the food and leave it out to thaw. Some use automatic feeders. I use both. Unregulated diabetics are literally starving at first as their bodies are not processing food well so it is fine to feed a little more than usual.

Lantus has an researched and documented protocol that works very well in felines. On this page, go down to the grey bar labeled Topics and read the starred topics under it. They have great info on how to dose, how to store, what dose to shoot when......http://www.felinediabetes.com/FDMB/viewforum.php?f=9

As far as what to feed, this website by an FD vet has lots of good info: http://www.catinfo.org Most of us fed dry food and most of feel it had a great impact on our cat's diagnosis. We now feed wet lo carb (8-10% or less). The brand and flavors depend on the cat. Here is the food chart we use: Janet and Binky’s chart

Keep reading and asking questions. We would love to help you help your cat.
 
Hi Karen! I can help with your diet concerns. I've dealt with both kidney disease and diabetes with my cats, and there are foods that are good for both conditions. At 15, you should be thinking about kidney health even if your cat hasn't been diagnosed with kidney disease, since it is so common in older cats.

Recent studies have shown that low protein diets are only helpful for cats in end-stage kidney failure. In fact, you don't want to feed very low protein diets to senior cats unless facing this situation, because it can cause muscle wasting. The three things you want to look for in a kidney-friendly diet are moisture, quality of protein, and low phosphorus content. There are several foods that fit all of these requirements and are low carb as well.

Here's an updated food list with the values for several premium foods (which have higher quality protein sources): https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50. You're looking for something with less than 10% carbs and less than 250 mg/kcal of phosphorus. The foods I would suggest are Merrick's Before Grain Beef, Merrick's Before Grain Turkey, Merricks' Cowboy Cookout, Merrick's Surf & Turf, Wellness Turkey, EVO 95% Chicken & Turkey, and Blue Wilderness Duck. Do not use the Binky chart when determining phosphorus content--while the carb values are still relevant, the phosphorus values are very much out of date, and several foods that used to be kidney friendly on the Binky charts now have insanely high phosphorus levels.

If those are out of your price range, the next best thing to feed are the low carb Friskie's Special Diet flavors. These are Turkey & Giblets and Salmon Dinner--make sure they are the ones that say "special diet" on the can. The protein isn't as high quality as the premium foods, but they are low phosphorus and and easy to find. PetSmart carries them, and some grocery stores.

Here is an updated list of just the phosphorus values for many commercial foods. They can be cross referenced with Binky's chart for carb values if there's something on there that you want to feed. On this chart, you're looking for something that is less than 1% phosphorus (these values are on a dry matter basis, not mg/kcal): http://www.felinecrf.org/canned_food_usa.htm.

For feeding frequency, it's better for diabetic cats to have multiple small meals throughout the day, rather than one or two big meals. I feed Bandit 4 times a day--every 6 hours. If I try to feed him less frequently than that, he'll tear my house apart. Many people here feed even more frequently than that. Some people also free feed the canned food--you just add some water to keep it fresh longer. Bandit is a gobbler, so I have to do scheduled feeding times. When he was on insulin, he ate at shot time (7am and 7pm), and at his nadir (the lowest number of the cycle), which was about 6 hours after his shots at 1pm and 1am. I had to work all day so I wasn't home to feed him at 1pm, so I froze portions of his cat food in little baggies and put them in my auto feeder before I left for work, which released the food at his meal time. This is the Auto feeder I own, but many people here have this one and like it alot as well.
 
Thanks for the helpful info. It is rather overwhelming to see how many new posts there were , just today , for folks who are in my position. You might think feline diabetes is epidemic! Before last week I was clueless that cats even got diabetes!

Good to know I can feed frequently since that is what my cat is used to. Would it be best to stop the high carb, grain-filled IAMS immediately and go to an all meat food, if the cat will take it? The vet thinks I shouldn't change the diet at all until the cat gets stabilized with insulin, but from what I've read, the dry food is likely the culprit and some report a pretty quick improvement in BG levels just by changing the diet.
 
As long as you are home testing, changing the diet is fine. (I am assuming your numbers are from home testing, not vet tests?). If not testing at home, we would urge you to start now.

Often the blood glucose levels go down when the cat starts eating all wet LO carb. When we switched Oliver from dry to wet, he came down 100 points overnight. If we hadn't been tested and had given our usual dose, he would have hypoed.
 
KarenAmelia said:
... You might think feline diabetes is epidemic! ...
Click to expand...

There is a theory that it may be epidemic, probably because we believed the pet food manufacturers and because vets only get a couple of hours on diet and nutrition, unless they deliberately seek additional training.


If you haven't already done so, check Cat Info for a good presentation on feline diet and nutrition.
 
It's far easier to do the diet change sooner than later--if you keep your cat on the high carb Iams, it's likely she'll never get regulated. Unfortunately, many vets don't understand the connection between high carb foods and blood glucose levels. It would be like trying to regulate a human with type 2 diabetes who was overeating as much McDonald's food as they wanted every day. No doctor would ever say, "let's wait and and regulate you before we change you to a healthier diet." They would tell you to first change your diet, and then you would stand a better chance at being regulated. It's exactly the same with cats.

However, and this is very important, switching to a low carb diet will likely drastically reduce her need for insulin almost immediately. Cats will drop 100-200 points right off the bat when the dry food is removed. This can lead to a deadly hypo incident if you're not home testing and the dose is not reduced. Amelia doesn't have terribly high numbers on the 1.5u she's on right now, so please make sure you reduce the dose when you ditch the dry food, and that you're testing daily.

Have you started home testing yet? Vet numbers are often unreliable because stress will raise a cat's blood sugar, and should not be used to determine dose adjustments. Lantus is a wonderful insulin, and with the the combination of a low carb wet diet and tight regulation via home testing, Amelia has an 80+% chance of no longer needing insulin. Cats have amazing remission rates when the right treatment guidelines are followed.
 
Thanks Julia, Sue, and BJM.

I was feeling a bit panicked because my cat's pre inject reading this evening was 435! (and yes, I am doing the BG testing myself; it seems pretty easy and the cat - her name is Terra - is very compliant.) This is hard : I feel so helpless and want to do something proactive RIGHT NOW to help my cat, and know that I have to wait and be patient. I do not have a means of testing for Ketones, as I am unable to monitor when she pees, and wonder if that is going to be a weakness in my caring for her.

I think that I misread the syringe, and dosed her too low this a.m. I was confused by the 0 line on the syringe and by the fact that, if you push the plunger hard, the bottom of the plunger lines up with the 0 marking. So I thought I needed to read from the bottom of the plunger seal, rather than from the top. Using this kind of syringe is very tricky as it doesn't have .5 unit markings, which makes for a lot of guesswork in partial units. And in such small doses, the little bit that gets included by the space in the syringe below the 0 line seems like it could be significant. My vet's instruction was cursory, and he assumed (and I did at the time) that I understood these details.

I appreciate the kind and helpful words of advice! Will be back!
 
Welcome to the board! Everyone here is great & can help with all your needs. GL to you & your kitty during this journey! :mrgreen:
 
Welcome to you and your baby...
I feed my 2 girls canned foods with water. I feed as soon as my feet hit the floor in the am....4:30. Then if the food is gone when I go to leave, I will refill a bit (about 1/2 the amount). I also put down raw foods that I grind. As soon as I hit the door aprox. 3:30 - 4:30pm, I thow out anything that might be left (usually not) and redo. I will also redo before I go to bed. I will put out a little less than 1/2 can of friskies and less than 1/2 can of f. feast and about 3 1/2 oz of raw each am time and when I first get home. I am also feeding 2 from this amount.
Keep in mind that Bean is in remission now. Before remission, I would test then feed, wait a min or so (make sure she did not throw up for any reason) and shoot while she was finishing up. The most important thing is to hold off foods 2 hrs before shot time and test so that food doesnt enterfer w/ test. If Bean ever needs insulin again, I will purchase a timer feeder like others use here.
Good luck w/ your furry baby
 
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